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. 2018 Mar 27;18(1):327.
doi: 10.1186/s12885-018-4240-x.

Nomograms predict long-term survival for patients with periampullary adenocarcinoma after pancreatoduodenectomy

Chaobin He  1 , Yize Mao  1 , Jun Wang  1 , Fangting Duan  1 , Xiaojun Lin  1 , Shengping Li  2
Affiliations

Nomograms predict long-term survival for patients with periampullary adenocarcinoma after pancreatoduodenectomy

Chaobin He et al. BMC Cancer. .

Abstract

Background: The prognosis of patients with periampullary adenocarcinoma after pancreatoduodenectomy is diverse and not yet clearly illustrated. The aim of this study was to develop a nomogram to predict individual risk of overall survival (OS) and progression-free survival (PFS) in patients with periampullary adenocarcinoma after pancreatoduodenectomy.

Methods: A total of 205 patients with periampullary adenocarcinoma after pancreatoduodenectomy were retrospectively included. OS and PFS were evaluated by the Kaplan-Meier method. Two nomograms for predicting OS and PFS were established, and the predictive accuracy was measured by the concordance index (Cindex) and calibration plots.

Results: Lymph node ratio (LNR), carbohydrate antigen 19-9 (CA19-9) and anatomical location were incorporated into the nomogram for OS prediction and LNR, CA19-9; anatomical location and tumor differentiation were incorporated into the nomogram for PFS prediction. All calibration plots for the probability of OS and PFS fit well. The Cindexes of the nomograms for OS and PFS prediction were 0.678 and 0.68, respectively. The OS and PFS survival times were stratified significantly using the nomogram-predicted survival probabilities.

Conclusions: The present nomograms for OS and PFS prediction can provide valuable information for tailored decision-making for patients with periampullary adenocarcinoma after pancreatoduodenectomy.

Keywords: Nomogram; Pancreatoduodenectomy; Periampullary adenocarcinoma; Prediction; Prognosis.

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Conflict of interest statement

Ethics approval and consent to participate

This study was approved by the Institutional Review Board (IRB) of the Sun Yat-sen University Cancer Center. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Written informed consent was obtained from patients prior to treatment.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Kapaln-Meier curves for OS according to LNR (P = 0.015, a CA19–9 (P = 0.007, b and anatomical location (P = 0.006, c
Fig. 2
Fig. 2
Kapaln-Meier curves for PFS according to LNR (P = 0.019, a CA19–9 (P = 0.014, b Tumor differentiation (P = 0.001, c and anatomical location (P = 0.001, d
Fig. 3
Fig. 3
Nomogram-predicted probabilities of 1-, 2-, and 3-years OS of patients with periampullary adenocarcinoma after pancreatoduodenectomy. The nomogram is used by adding up the points identified on the scale for three or four variables. The sum is located on the “Total points” scale, and a line is drawn downward to the survival axes to determine the probability of 1-, 2-, and 3-years OS
Fig. 4
Fig. 4
Nomogram-predicted probabilities of 1-, 2-, and 3-years PFS of patients with periampullary adenocarcinoma after pancreatoduodenectomy
Fig. 5
Fig. 5
The calibration plots of the nomogram set for 1-, 2-, and 3- years OS (a, b, c) and PFS (d, e, f) prediction. X-axis represents the nomogram-predicted probability of survival; Y-axis represents the actual OS or PFS probability estimated using the Kaplan-Meier method. The diagonal line indicates the ideal nomogram reference. The line containing error bars (95% CI) represents the performance for predicting OS or PFS of the nomogram applied to the study cohort
Fig. 6
Fig. 6
Kaplan-Meier survival curves for OS (a) or PFS (b) according to the risk levels of nomogram-predicted survival probabilities (P < 0.001)
See this image and copyright information in PMC

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